Dermal Filler: Acellular human cadaveric dermis (AlloDerm)

Generic name: Acellular human cadaveric dermis

Brand(s): AlloDerm

Maker / Website: LifeCell Corporation (www.lifecell.com)

Cost: $3,000 - $5,000

Allergy test required: No

Durability: Durability data are still limited; possibly around 2 years or longer, on average.

Function / Purpose:
Treatment of deep wrinkles, folds and furrows, particularly smile lines and frown lines; lip augmentation; sizable depressed scars.

Summary:
Essentially, AlloDerm (a.k.a. Allograft Dermal Matrix Graft) is specially-treated cadaver dermal matrix. It is stripped off all cells and other components that might trigger immune reaction or transmit infection. It is also strengthened to improve durability. When implanted, AlloDerm Matrix is supposed to become populated with your own cells and eventually be fully integrated into your skin.

Contraindications:
Use of AlloDerm in patients exhibiting autoimmune connective tissue disease is not recommended. AlloDerm is contraindicated in infected or nonvascular surgical sites. Donor tissue used to produce AlloDerm is supplied in an antibiotic-supplemented medium. AlloDerm may contain trace amounts of antibiotics listed on the outer pouch. AlloDerm should not be used in patients sensitive or allergic to these specific antibiotics.

Details:
The idea behind AlloDerm is to restore skin matrix in areas where it has been partially lost (such is under furrows and folds) by implanting a fragment of a donor's dermal matrix. When matrix is restored, it becomes populated with your own cell, which eventually create some matrix of their own, thus making the implant fully integrated into your skin. At least in theory, such approach is significantly more durable that traditional collagen injections.

AlloDerm is manufactured by LifeCell Corporation from Palo Alto, California. The donor tissue is obtained from cadavers at the time of death. The donor is tested for various diseases, such as HIV and hepatitis. The dermal allograft is prepared by separating dermis from the epidermis and removing all cells and DNA to further minimize the immunogenicity and the risk of disease transmission. What remains is the dermal matrix itself, particularly collagen and related proteins. The donor matrix serves not only as a filler but also to provide scaffolding for the recipient's own cells to attach to. As opposed to injectable fillers, AlloDerm has to be implanted via a small incision. A micronzied, injectable form of AlloDerm is available under the brand name Cymetra but appears to be less durable.

Notably, cosmetic procedures are not the primary use of AlloDerm: it is extensively used in burn treatment, surgical repairs and so forth.

AlloDerm can be quite durable (reportedly up do several years) because it integrates with the recipient's own tissue as it gets populated with the recipient's fibroblasts and meshes together with local matrix. However, since the quality of integration and the rate of matrix degradation vary from person to person, the durability of AlloDerm tends to vary substantially.